"To get rich is glorious." -- Deng Xiaoping. This is perhaps the smartest thing ever uttered by a member of the Communist Party.

Monday, April 27, 2009

Sneak preview

The Obama Administration offers up a sneak preview of socialized medicine:

Obama administration officials, alarmed at doctor shortages, are looking for ways to increase the supply of physicians to meet the needs of an aging population and millions of uninsured people who would gain coverage under legislation championed by the president.

The officials said they were particularly concerned about shortages of primary care providers who are the main source of health care for most Americans.

One proposal — to increase Medicare payments to general practitioners, at the expense of high-paid specialists — has touched off a lobbying fight.

Family doctors and internists are pressing Congress for an increase in their Medicare payments. But medical specialists are lobbying against any change that would cut their reimbursements. Congress, the specialists say, should find additional money to pay for primary care and should not redistribute dollars among doctors — a difficult argument at a time of huge budget deficits.

Some of the proposed solutions, while advancing one of President Obama’s goals, could frustrate others. Increasing the supply of doctors, for example, would increase access to care but could make it more difficult to rein in costs.

This story illustrates two things. First, contrary to the image of U.S. healthcare as an exercise in capitalism run amok, the government plays a massive role as this graph illustrates, with Medicare/aid combining for about a third of all health care spending:

National Spending on Health Care as a Percentage of GDP

Second, and most important, is that government -- like everyone else -- faces tradeoffs. If they want more of one thing that means having to give up something else -- in this example the tradeoff is between general practitioners and specialists.

Under government-run health care the people given the ultimate say will be politicians. The people that will influence those politicians will be lobbyists. This doesn't strike me as an improvement.